Description
We’re building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
As a case manager, you will coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers.
Responsibilities:
- Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
- Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care.
- Interacts with members/clients telephonically or in person.
- Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status.
- Communicates with member/client and other stakeholders as appropriate.
- Prepares all required documentation of case work activities.
- Interacts and consults with internal multidisciplinary team.
- May make outreach to treating physician or specialists concerning course of care and treatment.
- Provides educational and prevention information for best medical outcomes.
- Applies all laws and regulations that apply to the provision of rehabilitation services.
- Conducts an evaluation of members/clients’ needs and benefit plan eligibility.
- Utilizes case management processes in compliance with regulatory and company policies and procedures.
- Facilitates appropriate condition management, optimize overall wellness and medical outcomes.
- Develops a proactive course of action to address issues presented.
- Monitors member/client progress toward desired outcomes.
Requirements:
- Active and unrestricted RN licensure in Michigan
- 3+ years of clinical practical experience
- 2+ years of case management, discharge planning and/or home health care coordination experience
- Proficiency with standard corporate software applications
- Able to work in a fast-paced high-volume environment
- Efficient and effective computer skills
- Working knowledge of problem-solving and decision-making skills
- Working knowledge of medical terminology
- Working knowledge of digital literacy skills
- Ability to deal tactfully with customers and community
- Ability to handle sensitive information ethically and responsibly
Preferred Qualifications:
- National professional certification
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal skills
- Bilingual - Spanish
Education:
- Associate's Degree in Nursing (REQUIRED)
- Bachelor's Degree in Nursing (PREFERRED)
Benefits:
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs